31A-8-209. Minimum capital or minimum permanent surplus.
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Effective 5/6/2026
31A-8-209. Minimum capital or minimum permanent surplus.
(a)A health maintenance organization being organized or operating under this chapter shall have and maintain a minimum capital or minimum permanent surplus of $100,000.
(b)Each health maintenance organization authorized to do business in this state shall have and maintain qualified assets as defined in Subsection 31A-17-201(2) in an amount not less than the total of:
(i)the health maintenance organization's liabilities;
(ii)the health maintenance organization's minimum capital or minimum permanent surplus required by Subsection (1)(a) ; and
(iii)the greater of:
(A)the company action level RBC as defined in Subsection 31A-17-601(8)(b) ; or
(B)$1,300,000.
(a)Except as provided in Subsection
(3), the minimum required capital or minimum permanent surplus for a limited health plan may not:
(i)be less than $10,000; or
(ii)exceed $100,000.
(b)The initial minimum required capital or minimum permanent surplus for a limited health plan required by Subsection (2)(a) shall be set by the commissioner, after:
(i)a hearing; and
(ii)consideration of:
(A)the services to be provided by the limited health plan;
(B)the size and geographical distribution of the population the limited health plan anticipates serving;
(C)the nature of the limited health plan's arrangements with providers; and
(D)the arrangements, agreements, and relationships of the limited health plan in place or reasonably anticipated with respect to:
(I)insolvency insurance;
(II)reinsurance;
(III)lenders subordinating to the interests of enrollees and trade creditors;
(IV)personal and corporate financial guarantees;
(V)provider withholds and assessments;
(VI)surety bonds;
(VII)hold harmless agreements in provider contracts; and
(VIII)other arrangements, agreements, and relationships impacting the security of enrollees.
(c)Upon a material change in the scope or nature of a limited health plan's operations, the commissioner may, after a hearing, alter the limited health plan's minimum required capital or minimum permanent surplus.
(a)An ambulance membership organization organized under this chapter shall:
(i)establish and maintain a funded reserve account consisting of unencumbered assets of either cash or cash equivalents, equal to at least 20% of the gross earned fee income the ambulance membership organization receives on all active ambulance membership contracts that the ambulance membership organization sells or renews in this state on or after May 6, 2026;
(ii)post a surety bond with one or more surety companies that the commissioner approves in an amount of at least $5,000 for every 100 members of the ambulance membership organization who are residents of this state;
(iii)maintain additional securities the commissioner requires by rule in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and
(iv)pay the costs of collection upon a judgment in favor of a member and attorney fees in a successful action brought by member against the ambulance membership organization.
(b)The reserve account described in Subsection (3)(a) shall be:
(i)maintained in a financial institution that the commissioner approves; and
(ii)a separate, auditable account for the ambulance membership organization's ambulance membership contracts in force in this state.
(4)The commissioner may allow the minimum capital or permanent surplus account of an organization to be designated by some other name.
(5)A pattern of persistent deviation from the accounting and investment standards under this section may be grounds for the commissioner to find that the one or more persons with authority to make the organization's accounting or investment decisions are incompetent for purposes of Subsection 31A-5-410(3) .
Amended by Chapter 45 , 2026 General Session